Evans, John Charles
Evans, John Charles is an individual health care provider with primary practice located at 112 S Northwest Hwy , Park Ridge IL 60068-4260. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Occupational Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Evans, John Charles can be contacted via phone (847) 696-3370.Contact Information
Primary practice address
112 S Northwest Hwy
Park Ridge IL 60068-4260
Phone: (847) 696-3370
Fax: (847) 696-9445
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 36108128 | Illinois |
| Allopathic & Osteopathic Physicians / Occupational Medicine | 2083X0100X | 36108128 | Illinois |
Profile Details
| NPI number | 1003964156 |
|---|---|
| LBN Legal business name | Evans, John Charles |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 8th, 2007 |
| Last updated | Mar 30th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003964156 | NPPES |
| Illinois | MEDICAID | 036108128 |
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